[unreadable] [unreadable] Reminder/recall has been demonstrated to be an effective means of improving vaccination rates among children, yet its use has not been widely adopted. Immunization providers cite perceived staff time and cost as major factors impeding the adoption of reminder/recall. The proposed study will assess the effectiveness of a centralized reminder/recall intervention toward improving the immunization status of children in the urban area of Detroit, MI. Three reminder/recall strategies will be employed during the intervention: 7-month recall of children who are not up-to-date for vaccine recommended for receipt by six months of age; 12-month reminder for all children, to emphasize vaccination early in the second year of life; and 19-month recall of children who are not up-to-date for the primary immunization series. For each of the 3 strategies, an intervention arm will be paired with a control arm, to serve as the basis for assessment of reminder/recall effectiveness. The 3 strategies will be implemented and assessed independently, and compared to each other with regard to cost-effectiveness. [unreadable] [unreadable] The specific aims are to 1) develop a centralized reminder/recall intervention, that targets key age groups, incorporates the needs and preferences of both immunization providers and parents, and builds on existing capabilities of a high-functioning statewide immunization registry; 2) conduct a randomized controlled trial of the centralized reminder/recall intervention in a large urban area with historically low vaccination rates; and 3) evaluate the cost-effectiveness of each reminder/recall intervention strategy, to inform future efforts to implement centralized reminder/recall systems. [unreadable] [unreadable] The proposed project is unique in that it focuses on a large, racially and socioeconomically diverse, urban area with documented low vaccination rates; it features 3 different reminder/recall strategies targeted to key points in the children's vaccination schedule; it encompasses both personalized, patient-directed reminder/recall and vaccine-specific provider cues to action; and it incorporates a rigorous randomized controlled design. Results from the proposed study will provide reliable cost and effect-size estimates for the use of immunization information systems for centralized reminder/recall efforts. [unreadable] [unreadable] [unreadable]